CT在原发性醛固酮增多症病因诊断中的价值

The value of CT in the etiological classification of primary aldosterouism

目的评价CT在诊断原发性醛固酮增多症（PA）分类中的临床应用价值。方法回顾性分析同时行CT及肾上腺静脉取血（AVS）的17例临床诊断为PA患者的资料，以AVS结果作为金标准，进行病因分析。结果CT诊断双肾上腺未见异常7例，单侧或双侧结节6例，单侧肾上腺增粗2例，双侧肾上腺增粗1例，一侧增粗并对侧结节1例。在15例经AVS证实为单侧或双侧肾上腺增生的患者中，7例CT表现正常，3例CT表现为单侧或双侧肾上腺增粗或结节状，经AVS证实为双侧增生，仅5例患者CT表现与AVS结果一致。17例经AVS诊断为单侧或双侧醛固酮分泌过多的患者有7例CT表现正常。结论CT在原发性醛固酮增多症病因诊断方面特异性较差。

Objective To assess the clinical value of CT in the identification of the etiology of primary aldosteronism（PA）. Methods Seventeen cases who underwent both adrenal vein sampling（AVS） and CT examination were retrospectively investigated. By using results of AVS as gold standard, we evaluated CT in the determination of the etiology of （PA）. Results Seven cases showed no abnormalities on CT, and six cases exhibited unilateral or bilateral nodules. Enlarged configuration was found bilaterally in 2 cases and unilaterally in one case, and in another case with contralateral nodules. In 15 cases with bilateral adrenal hyperplasia （BAH） proved by AVS, 7 cases had normal CT imaging, 5 cases showed CT findings consistent with AVS, and 3 cases showed intermediate findings. Conclusion CT imaging is unreliable in the identification of the etiology of PA, especially in the diagnosis of BAH.